Monday, September 8, 2014

Invitation to Councillors to Visit 10 Downing Street

Councillors in Barking & Dagenham, Havering and Redbridge were written to last week per the below
Dear Councillors

We are writing to all Councillors in Redbridge, Havering and Barking and Dagenham to ask if you would like to come to deliver a letter to 10 Downing St on 12:00pm on Friday 26th September 2014 asking for the closure of King George Hospital A&E to be abandoned and the return of maternity to the King George Hospital site.

We would welcome Councillors from all three boroughs and all parties to attend.
The link here

shows the last time in April 2011 a letter was handed to 10 Downing Street on the issue.
The decision to close King George Hospital A&E was made in October 2011. However, the A&E remains open, but both Queens and King George Hospitals have been put into special measures for being unable to provide safe care at all times.

Queens and other London maternity units regularly close their doors as they are unable to cope with demand. BHRUT has identified a shortage of child beds locally which puts children at risk of poor care. The purpose of the photoshoot outside number 10 will be to seek to persuade the government to abandon the plan to close King George Hospital A&E and reopen the maternity unit.

The closure plans damages health care in our hospitals because medical staff do not want to work at King George Hospital A&E when it is due to close, nor do staff want to work at Queen's when thousands of extra patients are due to be sent to a hospital that cannot cope safely with the existing demand.


Bob Archer Bill Howe Andy Walker
C/O 120 Blythswood Road IG3 8SG 07956 263088

PS since writing the above Andy attended the BHRUT board meeting and AGM.
Page 115 reports a death at the special care baby unit (SCBU3), the text is copied below. The emphasis is mine

At the meeting held in June the Panel heard two cases that had occurred within the
Children’s Directorate. There were a number of issues that the Panel is seeking further
assurance on and this has been requested from the Directorate.
The first case discussed was a child with complex medical problems who attended the
emergency department. The other case was a neonatal death that occurred within
SCBU3. Actions that the Panel has requested following review of these investigation
reports are:
 Establish an alert system on Symphony4 to immediately identify children with
complex medical needs.
 Complete a gap analysis on competencies and capabilities on Inra-Osseous
cannula usage.
 Produce a flow chart that demonstrates the level of care escalation process within
Examine the level of competencies of locum doctors covering shifts within the
Trust and how this is assured.
Extract Ends

BHRUT clearly has doubts about the competency of locum doctors at KGH and Queens. The proposed closure of KGH A&E along with a reduction in medical staff of 25% over 4 years (page 123 of the attached decision making business case) has to be a factor in why medical staff do not want to work at either Queens or KGH on a permanent basis.

Although the targets in the decision making business case are not being achieved, it still determines strategy at BHRUT.
This is from the AGM papers at page 14 (my emphasis)

The Trust’s clinical strategy seeks to improve quality of care, generate benefits in
centralising acute services and strengthening staffing levels, while enhancing urgent
care and out of hospital care where appropriate. It is underpinned by the clinically-led Health for North East London plans (HfNEL) set out by commissioners in 2010 following major public consultation.

In summary, the key elements of our clinical strategy (some of which have now been
implemented) that were developed in line with HfNEL are:
Unplanned care: Stabilise its emergency care provision and performance at QH
before implementing any plans to move emergency activity from KGH to QH. The
‘Front Door’ model is under review as part of the implementation plan. This will
influence access and flow through the Emergency Department

Planned care: Maximise use of the Queen’s site for complex inpatient activity, and the
use of KGH for day case, short stay elective and diagnostic activity, including
developing a dedicated breast services unit on the KGH site

Integrated care: Relocate and develop additional intermediate and rehabilitation
services at KGH and, subject to consultation, potentially centralise community
services on the KGH site.

Maternity services: KGH maternity services were successfully moved to Queen’s in
2013, with an antenatal and associated service remaining at KGH

Children’s services: A focus for specialist paediatrics at Queen’s, with paediatric
inpatients and the Special Care Baby Unit to move to Queen’s and paediatric day
case, elective and planned diagnostics to be centralised at KGH. To develop a
women’s and children’s unit at KGH that will aim to provide a fully centralised breast
service at KGH. END of Extract

However, there are grounds for optimism that BHRUT is considering abandoning support for the KGH closure plan along with the large bed and staffing reductions entailed. Futher on at page 14 (my emphasis)
Although the Trust is committed to following through on the above elements and
delivering them, before embarking on any other aspects, we have asked for a major
piece of work
to take place to look again at the data – including projected population
and demand – that was used to develop the original Health for North East London
proposals. Extract ends

BHRUT may be concerned that closing KGH A&E is no longer feasible due to larger than expected population growth. A very welcome development.

Finally, 4 hour waiting times at A&E, a vital key performance indicator, and one of the reasons Queens and KGH A&E were found unsafe last year and the trust put into special measures remain well below the recommended safe level of 95%. Mr Russell, BHRUT deputy Chief Executive spoke of a deteriorating position for the August figures at the ordinary board meeting yesterday. The exact figure will be published shortly.

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